| National Provider Identifier [NPI]: | 1396755625 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1088 W BALTIMORE PIKE |
| Street Address 2 Of The Provider | SUITE #2206 |
| City Of The Provider | MEDIA |
| Zip Code Of The Provider | 190635146 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 4535 |
| Number Of Medicare Beneficiaries | 833 |
| Total Submitted Charge Amount | 491015 |
| Total Medicare Allowed Amount | 405351.01 |
| Total Medicare Payment Amount | 299919.06 |
| Total Medicare Standardized Payment Amount | 284887.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 137 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 7484 |
| Total Drug Medicare AllowedAmount | 5361.71 |
| Total Drug Medicare PaymentAmount | 5237.59 |
| Total Drug Medicare Standardized Payment Amount | 5237.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 4398 |
| Number Of Medicare Beneficiaries With Medical Services | 833 |
| Total Medical Submitted Charge Amount | 483531 |
| Total Medical Medicare Allowed Amount | 399989.3 |
| Total Medical Medicare Payment Amount | 294681.47 |
| Total Medical Medicare Standardized Payment Amount | 279650.14 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 271 |
| Number Of Female Beneficiaries | 510 |
| Number Of Male Beneficiaries | 323 |
| Number Of Non Hispanic White Beneficiaries | 752 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 495 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5436 |